Can LASIK be repeated for long sightedness years after correction for myopia?

The concern about presbyopia in the forties after Lasik in the twenties or thirties is totally relevant.

The truth is Lasik can be repeated or “enhanced”, either to treat residual short-sight or overcorrection causing ling-sightedness, so long as the corneal measurements allow it.

Repeat Lasik to improve near vision after previous Lasik for short sightedness can and has been done, and done well before. However, the potential candidate needs to understand what it involves. Lasik for presbyopia works on the basis of

1) monovision, in which one eye is made slightly short-sighted to focus near, hence sacrificing far vision somewhat in this eye, and the other eye (the dominant eye) is left sharp for far. This often works well when both eyes work together (binocularly).

2) adjustment of sphericity. This refers to adjustment of the higher order power of the cornea, to make its shape more able to focus over a slightly wider range of distance. This is usually combined with monovision Lasik treatment, in the eye meant to focus near. This is possible in several more advanced “excimer-based” Lasik treatment

In all cases, adjusting to focus near after previous Lasik which targeted for zero power will mean losing some sharpness for far vision in one eye, in return for improved reading /near vision. This is the “give and take” of such cases.

This principle is no different from, for instance, cataract surgery employing monovision strategy after previous Lasik.

I hope that my answer, which may differ from others, are able to give a different perspective of this topic.

Cheerio

Daphne Han

Senior Consultant, Ophthalmologist

If by 'longsightedness' you mean 'presbyopia' or in Chinese 'Lao Hua', then LASIK is not a method that can treat this no matter whether someone had prior correction for myopia or not.

Again, LASIK is not and cannot be used to treat presbyopia per se.

You might find prior answers to this related question interesting: https://www.human.com.sg/questions/is-it-possible-to-go-for-lasik-again-if-i-now-have-presbyopia

On the other hand, if someone did unexpectedly develop true longsightedness (hyperopia) some years after LASIK, it is usually possible to retreat/enhance with a second LASIK to correct the hyperopia. This can usually be done by relifting the original LASIK flap, or alternatively by performing a surface ablation/epiLASIK/PRK type procedure.

This is a common question. It's important to stress that long-sightedness affects all of us after the age of 40 years. This is due to the loss of the lens-fiber elasticity so the normal lens in our eye loses the ability to change its refractive accommodative power (hence becomes unable to read / see near objects).

Unfortunately there is no procedure that is able to correct the loss of lens flexibility. The most common option offered to patients to compensate for their presbyopia is

1. monovision - dominant eye for distance vision, non-dominant eye for near / intermediate vision
2. presby-Lasik - where the cornea is reshaped into different zones of refractive power (similar to a multifocal contact lens).

To determine your suitability for either of these procedures after your primary Lasik procedure should be discussed in depth with your Ophthalmologist. Much of this depends on your post-operative corneal thickness which determines whether you are suitable for subsequent Lasik enhancement in future.

Best of luck with your Lasik procedure!

ESG